Preview

Кардиология

Расширенный поиск

Нарушения системы дыхания при хронической сердечной недостаточности

https://doi.org/10.18087/cardio.2626

Полный текст:

Аннотация

В обзоре обсуждаются механизмы развития патологии системы внешнего дыхания у пациентов с ХСН, в частности, различные варианты периодического дыхания, легочная гипертензия вследствие патологии левых камер сердца и ремоделирование дыхательной мускулатуры. Обсуждается роль хемо- и барорецепторов каротидной зоны, а также гиперактивации метаборефлекса дыхания в развитии патологии системы внешнего дыхания и опосредованном усугублении сердечной недостаточности.

Об авторах

Ю. Л. Беграмбекова
«МНОЦ МГУ им. М. В. Ломоносова».
Россия
119192, Москва, Ломоносовский пр‑кт, д. 27, корп. 10.


Н. А. Каранадзе
«МНОЦ МГУ им. М. В. Ломоносова».
Россия
119192, Москва, Ломоносовский пр‑кт, д. 27, корп. 10.


Я. А. Орлова
«МНОЦ МГУ им. М. В. Ломоносова».
Россия
119192, Москва, Ломоносовский пр‑кт, д. 27, корп. 10.


Список литературы

1. Мареев В. Ю., Фомин И. В., Агеев Ф. Т., Беграмбекова Ю. Л., Васюк Ю. А., Гарганеева А. А. и др. Клинические рекомендации ОССН – РКО – РНМОТ. Сердечная недостаточность: хроническая (ХСН) и острая декомпенсированная (ОДСН). Диагностика, профилактика и лечение. Кардиология. 2018;58(S6):8–164. [Mareev V. Yu., Fomin O. V., Ageev F. T., Begrambekova Yu. L., Vasyuk Yu. A., Garganeeva A. A. et al. Russian Heart Failure Society, Russian Society of Cardiology. Russian Scientific Medical Society of Internal Medicine Guidelines for Heart failure: chronic (CHF) and acute decompensated (ADHF). Diagnosis, prevention and treatment. Kardiologiia. 2018;58(S6):8-164.]. DOI: 10.18087/cardio.2475

2. Warriner D, Sheridan P, Lawford P. Heart failure: not a single organ disease but a multisystem syndrome. British Journal of Hospital Medicine. 2015;76(6):330–6. DOI: 10.12968/hmed.2015.76.6.330

3. Schmidt H, Lotze U, Ghanem A, Anker SD, Said SM, Braun-Dullaeus R et al. Relation of impaired interorgan communication and parasympathetic activity in chronic heart failure and multiple-organ dysfunction syndrome. Journal of Critical Care. 2014;29(3):367–73. DOI: 10.1016/j.jcrc.2013.12.015

4. Ponikowski P, Chua TP, Anker SD, Francis DP, Doehner W, Banasiak W et al. Peripheral chemoreceptor hypersensitivity: an ominous sign in patients with chronic heart failure. Circulation. 2001;104(5):544–9. PMID: 11479251

5. Giannoni A, Emdin M, Bramanti F, Iudice G, Francis DP, Barsotti A et al. Combined Increased Chemosensitivity to Hypoxia and Hypercapnia as a Prognosticator in Heart Failure. Journal of the American College of Cardiology. 2009;53(21):1975–80. DOI: 10.1016/j.jacc.2009.02.030

6. Miller WL, Grill DE, Borlaug BA. Clinical Features, Hemodynamics, and Outcomes of Pulmonary Hypertension Due to Chronic Heart Failure with Reduced Ejection Fraction. JACC: Heart Failure. 2013;1(4):290–9. DOI: 10.1016/j.jchf.2013.05.001

7. Galiè N, Humbert M, Vachiery J-L, Gibbs S, Lang I, Torbicki A et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). European Heart Journal. 2016;37(1):67–119. DOI: 10.1093/eurheartj/ehv317

8. Corrà U, Giordano A, Bosimini E, Mezzani A, Piepoli M, Coats AJS et al. Oscillatory Ventilation During Exercise in Patients with Chronic Heart Failure. Chest. 2002;121(5):1572–80. DOI: 10.1378/chest.121.5.1572

9. Kelley RC, Ferreira LF. Diaphragm abnormalities in heart failure and aging: mechanisms and integration of cardiovascular and respiratory pathophysiology. Heart Failure Reviews. 2017;22(2):191–207. DOI: 10.1007/s10741-016-9549-4

10. Hooijman PE, Beishuizen A, Witt CC, de Waard MC, Girbes ARJ, Spoelstra-de Man AME et al. Diaphragm Muscle Fiber Weakness and Ubiquitin–Proteasome Activation in Critically Ill Patients. American Journal of Respiratory and Critical Care Medicine. 2015;191(10):1126–38. DOI: 10.1164/rccm.201412-2214OC

11. Lindsay DC, Lovegrove CA, Dunn MJ, Bennett JG, Pepper JR, Yacoub MH et al. Histological abnormalities of muscle from limb, thorax and diaphragm in chronic heart failure. European Heart Journal. 1996;17(8):1239–50. PMID: 8869866

12. Dhakal BP, Lewis GD. Exercise oscillatory ventilation: Mechanisms and prognostic significance. World Journal of Cardiology. 2016;8(3):258. DOI: 10.4330/wjc.v8.i3.258

13. Mor A, Thomsen RW, Ulrichsen SP, Sørensen HT. Chronic heart failure and risk of hospitalization with pneumonia: A population-based study. European Journal of Internal Medicine. 2013;24(4):349–53. DOI: 10.1016/j.ejim.2013.02.013

14. Garatachea N, Lucía A. Genes and the ageing muscle: a review on genetic association studies. AGE. 2013;35(1):207–33. DOI: 10.1007/s11357-011-9327-0

15. Roth SM. Genetic aspects of skeletal muscle strength and mass with relevance to sarcopenia. BoneKEy Reports. 2012;1. DOI: 10.1038/bonekey.2012.58

16. Ueshima K, Kobayashi N, Yamazaki T, Saitoh M, Nakamura M, Nakao K. Clinical Significance of Awake Oscillatory Ventilation in Patients with Heart Failure and Effects of Open-Heart Surgery. Clinical Cardiology. 2010;33(7):E20–3. DOI: 10.1002/clc.20572

17. Cowie MR, Woehrle H, Wegscheider K, Angermann C, d’Ortho M-P, Erdmann E et al. Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure. New England Journal of Medicine. 2015;373(12):1095–105. DOI: 10.1056/NEJMoa1506459

18. Yamada K, Kinugasa Y, Sota T, Miyagi M, Sugihara S, Kato M et al. Inspiratory Muscle Weakness Is Associated with Exercise Intolerance in Patients With Heart Failure With Preserved Ejection Fraction: A Preliminary Study. Journal of Cardiac Failure. 2016;22(1):38–47. DOI: 10.1016/j.cardfail.2015.10.010

19. Matsuki R, Kisaka T, Ozono R, Kinoshita H, Sada Y, Oda N et al. Characteristics of Patients with Severe Heart Failure Exhibiting Exercise Oscillatory Ventilation. Clinical and Experimental Hypertension. 2013;35(4):267–72. DOI: 10.3109/10641963.2013.780071

20. Scardovi AB, De Maria R, Ferraironi A, Gatto L, Celestini A, Forte S et al. A case for assessment of oscillatory breathing during cardiopulmonary exercise test in risk stratification of elderly patients with chronic heart failure. International Journal of Cardiology. 2012;155(1):115–9. DOI: 10.1016/j.ijcard.2011.02.033

21. Sun X-G, Hansen JE, Beshai JF, Wasserman K. Oscillatory Breathing and Exercise Gas Exchange Abnormalities Prognosticate Early Mortality and Morbidity in Heart Failure. Journal of the American College of Cardiology. 2010;55(17):1814–23. DOI: 10.1016/j.jacc.2009.10.075

22. Oldenburg O, Lamp B, Töpfer V, Faber L, Teschler H, Horstkotte D. Prävalenz schlafbezogener Atemstörungen bei ischämischer und nicht-ischämischer Herzinsuffizienz. DMW - Deutsche Medizinische Wochenschrift. 2007;132(13):661–6. DOI: 10.1055/s-2007-973599

23. Pinna GD, Maestri R, Mortara A, Rovere MTL. Cardiorespiratory interactions during periodic breathing in awake chronic heart failure patients. American Journal of Physiology-Heart and Circulatory Physiology. 2000;278(3):H932–41. DOI: 10.1152/ajpheart.2000.278.3.H932

24. Andreas S, Hagenah G, Möller C, Werner GS, Kreuzer H. Cheynestokes respiration and prognosis in congestive heart failure. The American Journal of Cardiology. 1996;78(11):1260–4. DOI: 10.1016/S0002-9149(96)00608-X

25. Hanly PJ, Zuberi-Khokhar NS. Increased mortality associated with Cheyne-Stokes respiration in patients with congestive heart failure. American Journal of Respiratory and Critical Care Medicine. 1996;153(1):272–6. DOI: 10.1164/ajrccm.153.1.8542128

26. Brack T, Thüer I, Clarenbach CF, Senn O, Noll G, Russi EW et al. Daytime Cheyne-Stokes Respiration in Ambulatory Patients with Severe Congestive Heart Failure Is Associated With Increased Mortality. Chest. 2007;132(5):1463–71. DOI: 10.1378/chest.07-0121

27. Piepoli M. Aetiology and pathophysiological implications of oscillatory ventilation at rest and during exercise in chronic heart failure. Do Cheyne and Stokes have an important message for modern-day patients with heart failure? European Heart Journal. 1999;20(13):946–53. DOI: 10.1053/euhj.1999.1506

28. Leite JJ, Mansur AJ, de Freitas HFG, Chizola PR, Bocchi EA, TerraFilho M et al. Periodic breathing during incremental exercise predicts mortality in patients with chronic heart failure evaluated for cardiac transplantation. Journal of the American College of Cardiology. 2003;41(12):2175–81. PMID: 12821243

29. Agostoni P. Exercise-Induced Pulmonary Edema in Heart Failure. Circulation. 2003;108(21):2666–71. DOI: 10.1161/01.CIR.0000097115.61309.59

30. Del Rio R, Marcus NJ, Schultz HD. Carotid Chemoreceptor Ablation Improves Survival in Heart Failure. Journal of the American College of Cardiology. 2013;62(25):2422–30. DOI: 10.1016/j.jacc.2013.07.079

31. Lam CSP, Roger VL, Rodeheffer RJ, Borlaug BA, Enders FT, Redfield MM. Pulmonary Hypertension in Heart Failure with Preserved Ejection Fraction. Journal of the American College of Cardiology. 2009;53(13):1119–26. DOI: 10.1016/j.jacc.2008.11.051

32. Leung CC, Moondra V, Catherwood E, Andrus BW. Prevalence and Risk Factors of Pulmonary Hypertension in Patients with Elevated Pulmonary Venous Pressure and Preserved Ejection Fraction. The American Journal of Cardiology. 2010;106(2):284–6. DOI: 10.1016/j.amjcard.2010.02.039

33. Vachiéry J-L, Adir Y, Barberà JA, Champion H, Coghlan JG, Cottin V et al. Pulmonary Hypertension Due to Left Heart Diseases. Journal of the American College of Cardiology. 2013;62(25):D100–8. DOI: 10.1016/j.jacc.2013.10.033

34. Fang JC, DeMarco T, Givertz MM, Borlaug BA, Lewis GD, Rame JE et al. World Health Organization Pulmonary Hypertension Group 2: Pulmonary hypertension due to left heart disease in the adult—a summary statement from the Pulmonary Hypertension Council of the International Society for Heart and Lung Transplantation. The Journal of Heart and Lung Transplantation. 2012;31(9):913–33. DOI: 10.1016/j.healun.2012.06.002

35. Rosenkranz S, Gibbs JSR, Wachter R, De Marco T, Vonk-Noordegraaf A, Vachiéry J-L. Left ventricular heart failure and pulmonary hypertension. European Heart Journal. 2016;37(12):942–54. DOI: 10.1093/eurheartj/ehv512

36. Rosenkranz S. Pulmonary hypertension 2015: current definitions, terminology, and novel treatment options. Clinical Research in Cardiology. 2015;104(3):197–207. DOI: 10.1007/s00392-014-0765-4

37. Collamati A, Marzetti E, Calvani R, Tosato M, D’Angelo E, Sisto AN et al. Sarcopenia in heart failure: mechanisms and therapeutic strategies. Journal of geriatric cardiology: JGC. 2016;13(7):615–24. DOI: 10.11909/j.issn.1671-5411.2016.07.004

38. Rosca MG, Hoppel CL. Mitochondrial dysfunction in heart failure. Heart Failure Reviews. 2013;18(5):607–22. DOI: 10.1007/s10741-012-9340-0

39. Rosca MG, Hoppel CL. New aspects of impaired mitochondrial function in heart failure. Journal of Bioenergetics and Biomembranes. 2009;41(2):107–12. DOI: 10.1007/s10863-009-9215-9

40. Hardin BJ, Campbell KS, Smith JD, Arbogast S, Smith J, Moylan JS et al. TNF-α acts via TNFR1 and muscle-derived oxidants to depress myofibrillar force in murine skeletal muscle. Journal of Applied Physiology. 2008;104(3):694–9. DOI: 10.1152/japplphysiol.00898.2007

41. Stasko SA, Hardin BJ, Smith JD, Moylan JS, Reid MB. TNF signals via neuronal-type nitric oxide synthase and reactive oxygen species to depress specific force of skeletal muscle. Journal of Applied Physiology. 2013;114(11):1629–36. DOI: 10.1152/japplphysiol.00871.2012

42. Barreiro E. Role of Protein Carbonylation in Skeletal Muscle Mass Loss Associated with Chronic Conditions. Proteomes. 2016;4(2):18. DOI: 10.3390/proteomes4020018

43. Lenk K, Schuler G, Adams V. Skeletal muscle wasting in cachexia and sarcopenia: molecular pathophysiology and impact of exercise training. Journal of Cachexia, Sarcopenia and Muscle. 2010;1(1):9–21. DOI: 10.1007/s13539-010-0007-1

44. Von Haehling S. The wasting continuum in heart failure: from sarcopenia to cachexia. Proceedings of the Nutrition Society. 2015;74(04):367–77. DOI: 10.1017/S0029665115002438

45. Lavietes MH, Gerula CM, Fless KG, Cherniack NS, Arora RR. Inspiratory Muscle Weakness in Diastolic Dysfunction. Chest. 2004;126(3):838–44. DOI: 10.1378/chest.126.3.838

46. Sieck GC, Fournier M. Diaphragm motor unit recruitment during ventilatory and nonventilatory behaviors. Journal of Applied Physiology (Bethesda, Md.: 1985). 1989;66(6):2539–45. DOI: 0.1152/jappl.1989.66.6.2539

47. Thomsen RW, Kasatpibal N, Riis A, Nørgaard M, Sørensen HT. The Impact of Pre-existing Heart Failure on Pneumonia Prognosis: Population-based Cohort Study. Journal of General Internal Medicine. 2008;23(9):1407–13. DOI: 10.1007/s11606-008-0672-3

48. Поляков Д. С., Фомин И. В., Валикулова Ф. Ю., Вайсберг А. Р., Краием Н. Оценка влияния внебольничной пневмонии на краткосрочный и долгосрочный прогноз у больного с декомпенсацией хронической сердечной недостаточности. Терапевтический Архив. 2016;88(9):17–22. [Polyakov D. S., Fomin I.V., Valikulova F.Yu., Vaisberg A.R., Kraiem N. Evaluation of the impact of community-acquired pneumonia on short-term and longterm prognosis in a patient with chronic decompensated heart failure. Therapeutic achive. 2016;88(9):17-22.]. DOI: 10.17116/terarkh201688917-22

49. Stupka JE, Mortensen EM, Anzueto A, Restrepo MI. Community-acquired pneumonia in elderly patients. Aging Health. 2009;5(6):763–74. DOI: 10.2217/ahe.09.74

50. Harms CA, Babcock MA, McClaran SR, Pegelow DF, Nickele GA, Nelson WB et al. Respiratory muscle work compromises leg blood flow during maximal exercise. Journal of Applied Physiology. 1997;82(5):1573–83. DOI: 10.1152/jappl.1997.82.5.1573

51. Harms CA, Wetter TJ, McClaran SR, Pegelow DF, Nickele GA, Nelson WB et al. Effects of respiratory muscle work on cardiac output and its distribution during maximal exercise. Journal of Applied Physiology. 1998;85(2):609–18. DOI: 10.1152/jappl.1998.85.2.609

52. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal. 2016;37(27):2129–200. DOI: 10.1093/eurheartj/ehw128

53. Мареев В. Ю., Фомин И. В., Агеев Ф. Т., Арутюнов Г. П., Беграмбекова Ю. Л., Васюк Ю. А. et al. Хроническая сердечная

54. недостаточность (ХСН). Журнал Сердечная Недостаточность.

55. ;18(1):3–40. [Mareev V. Yu., Fomin I. V., Ageev F. T., Arutyunov

56. G. P., Begrambekova Yu. L., Belenkov Yu. N. et al. Clinical guidelines.

57. Chronic heart failure (CHF). Russian Heart Failure Journal. 2017;18(1):3-40.]. DOI: 10.18087/rhfj.2017.1.2346

58. Арутюнов Г. П., Колесникова Е. А., Беграмбекова Ю. Л., Орлова Я. А., Рылова А. К., Аронов Д. М. и др. Рекомендации по назначению физических тренировок пациентам с хронической сердечной недостаточностью. Журнал Сердечная Недостаточность. 2017;18(1):41–66. [Arutyunov G. P., Kolesnikova E. A., Begrambekova Yu. L., Orlova Ia. A., Rylova A. K., Aronov D. M. et al. Exercise training in chronic heart failure: practical guidance of the Russian Heart Failure Society. Russian Heart Failure Journal. 2017;18 (1):41–66.]. DOI: 10.18087/rhfj.2017.1.2339

59. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ. 2004;328(7433):189–0. DOI: 10.1136/bmj.37938.645220.EE

60. Davies EJ, Moxham T, Rees K, Singh S, Coats AJS, Ebrahim S et al. Exercise training for systolic heart failure: Cochrane systematic review and meta-analysis. European Journal of Heart Failure. 2010;12(7):706–15. DOI: 10.1093/eurjhf/hfq056

61. Haykowsky MJ, Timmons MP, Kruger C, McNeely M, Taylor DA, Clark AM. Meta-analysis of aerobic interval training on exercise capacity and systolic function in patients with heart failure and reduced ejection fractions. The American Journal of Cardiology. 2013;111(10):1466–9. DOI: 10.1016/j.amjcard.2013.01.303

62. Wisløff U, Støylen A, Loennechen JP, Bruvold M, Rognmo Ø, Haram PM et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation. 2007;115(24):3086–94. DOI: 10.1161/CIRCULATIONAHA.106.675041

63. Meyer K. Resistance exercise in chronic heart failure – landmark studies and implications for practice. Clinical and Investigative Medicine. Medecine Clinique Et Experimentale. 2006;29(3):166–9. PMID: 17058436

64. Levinger I, Bronks R, Cody DV, Linton I, Davie A. The effect of resistance training on left ventricular function and structure of patients with chronic heart failure. International Journal of Cardiology. 2005;105(2):159–63. DOI: 10.1016/j.ijcard.2004.11.022

65. Selig SE, Carey MF, Menzies DG, Patterson J, Geerling RH, Williams AD et al. Moderate-intensity resistance exercise training in patients with chronic heart failure improves strength, endurance, heart rate variability, and forearm blood flow. Journal of Cardiac Failure. 2004;10(1):21–30. PMID: 14966771

66. Belardinelli R, Georgiou D, Cianci G, Purcaro A. Randomized, controlled trial of long-term moderate exercise training in chronic heart failure: effects on functional capacity, quality of life, and clinical outcome. Circulation. 1999;99(9):1173–82. PMID: 10069785

67. Palmer K, Bowles K-A, Paton M, Jepson M, Lane R. Chronic Heart Failure and Exercise Rehabilitation: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation. 2018; DOI: 10.1016/j.apmr.2018.03.015

68. Wu J, Kuang L, Fu L. Effects of inspiratory muscle training in chronic heart failure patients: A systematic review and meta-analysis. Congenital Heart Disease. 2018;13(2):194–202. DOI: 10.1111/chd.12586

69. Bernardi L, Gabutti A, Porta C, Spicuzza L. Slow breathing reduces chemoreflex response to hypoxia and hypercapnia, and increases baroreflex sensitivity. Journal of Hypertension. 2001;19(12):2221–9. PMID: 11725167

70. Bernardi L, Porta C, Spicuzza L, Bellwon J, Spadacini G, Frey AW et al. Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure. Circulation. 2002;105(2):143–5. PMID: 11790690

71. Joseph CN, Porta C, Casucci G, Casiraghi N, Maffeis M, Rossi M et al. Slow Breathing Improves Arterial Baroreflex Sensitivity and Decreases Blood Pressure in Essential Hypertension. Hypertension. 2005;46(4):714–8. DOI: 10.1161/01.HYP.0000179581.68566.7d

72. Bernardi L, Spadacini G, Bellwon J, Hajric R, Roskamm H, Frey AW. Effect of breathing rate on oxygen saturation and exercise performance in chronic heart failure. The Lancet. 1998;351(9112):1308–11. DOI: 10.1016/S0140-6736(97)10341-5

73. Pal G, Agarwal A, Karthik S, Pal P, Nanda N. Slow yogic breathing through right and left nostril influences sympathovagal balance, heart rate variability, and cardiovascular risks in young adults. North American Journal of Medical Sciences. 2014;6(3):145. DOI: 10.4103/1947-2714.128477

74. Sinha AN. Assessment of the Effects of Pranayama/Alternate Nostril Breathing on the Parasympathetic Nervous System in Young Adults. Journal of clinical and diagnostic research. 2013; DOI: 10.7860/JCDR/2013/4750.2948

75. Lin S-J, McElfresh J, Hall B, Bloom R, Farrell K. Inspiratory muscle training in patients with heart failure: a systematic review. Cardiopulmonary Physical Therapy Journal. 2012;23(3):29–36. PMID: 22993500

76. Mancini DM, Henson D, La Manca J, Donchez L, Levine S. Benefit of selective respiratory muscle training on exercise capacity in patients with chronic congestive heart failure. Circulation. 1995;91(2):320–9. PMID: 7805234

77. Geddes EL, O’Brien K, Reid WD, Brooks D, Crowe J. Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review. Respiratory Medicine. 2008;102(12):1715–29. DOI: 10.1016/j.rmed.2008.07.005

78. Арутюнов Г. П., Рылова Н. В., Колесникова Е. А., Рылова А. К. Тренировки дыхательной мускулатуры в программе реабилитации больных с ХСН III-IV ФК и легочной гипертензией. CardioСоматика. 2011;(S1):8. [Arutyunov G. P., Rylova N. V., Kolesnikova E. A., Rylova A. K. Respiratory muscle training in the rehabilitation program of patients with HSN III-IV FC and pulmonary hypertension. CardioSomatika. 2011;S1:8.]

79. Winkelmann ER, Chiappa GR, Lima COC, Viecili PRN, Stein R, Ribeiro JP. Addition of inspiratory muscle training to aerobic training improves cardiorespiratory responses to exercise in patients with heart failure and inspiratory muscle weakness. American Heart Journal. 2009;158(5):768.e1-768.e7. DOI: 10.1016/j.ahj.2009.09.005

80. Dall’Ago P, Chiappa GRS, Guths H, Stein R, Ribeiro JP. Inspiratory muscle training in patients with heart failure and inspiratory muscle weakness: a randomized trial. Journal of the American College of Cardiology. 2006;47(4):757–63. DOI: 10.1016/j.jacc.2005.09.052

81. Laoutaris ID, Dritsas A, Brown MD, Manginas A, Kallistratos MS, Degiannis D et al. Immune response to inspiratory muscle training in patients with chronic heart failure. European Journal of Cardiovascular Prevention & Rehabilitation. 2007;14(5):679–86. DOI: 10.1097/HJR.0b013e3281338394


Для цитирования:


Беграмбекова Ю.Л., Каранадзе Н.А., Орлова Я.А. Нарушения системы дыхания при хронической сердечной недостаточности. Кардиология. 2019;59(2S):15-24. https://doi.org/10.18087/cardio.2626

For citation:


Begrambekova Y.L., Karanadze N.A., Orlova Y.A. Alterations of the respiratory system in heart failure. Kardiologiia. 2019;59(2S):15-24. (In Russ.) https://doi.org/10.18087/cardio.2626

Просмотров: 361


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 0022-9040 (Print)
ISSN 2412-5660 (Online)